Noni is a plant that has been used in folk medicine for over 2,000 years in Polynesia. The Polynesians used noni as food, as well as for its antibacterial, antiviral, antifungal, antitumor, anti-parasitic, pain-relieving, blood pressure-lowering, anti-inflammatory, and immune effects.

Noni is a popular supplement. Many studies have reviewd the use of noni; however, strong human evidence is lacking. One trial suggests that noni may benefit people with nausea after surgery. Early research suggests that noni may have antioxidant, cholesterol-lowering, and anticancer activity. Although promising, more high-quality studies are needed.

Cases of liver damage in humans have been reported following noni juice consumption. However, the European Food Safey Authority (EFSA) states that strong evidence is lacking to support an association between noni juice consumption at dietary intake levels and liver problems. More research on the safety of noni is needed.

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

GRADE *

One trial shows that noni extract may reduce nausea after surgery. Higher doses (600 milligrams) may be most effective. More research is needed to confirm these early findings.

B

Studies suggest that Tahitian Noni® Juice, which contains noni fruit puree, grape juice, and blueberry juice, may have stronger antioxidant activity than some commonly used antioxidants. In healthy people, Tahitian Noni® Juice may decrease markers of oxidative stress. Tahitian Noni® Juice may also have significant antioxidant benefits in smokers. Further high-quality research is needed on the effects of noni alone.

C

Noni has been studied for possible benefit in people with cancer. Early research suggests that noni may improve physical function, pain, and fatigue. Noni may decrease the amount of structures in the body that lead to cancer. However, further high-quality research is needed before firm conclusions can be made.

C

Early research suggests that noni juice, combined with physical therapy, may improve neck pain and flexibility in people with cervical spondylosis. Although promising, further high-quality study is needed in this area.

C

Noni juice may enhance exercise performance in athletes. Although promising, more high-quality research is needed on the potential effects of noni alone.

C

Early research suggests that Tahitian Noni® Juice may reduce bleeding and inflammation in people with gum disease. However, it lacks an effect on bacteria levels in the mouth. Further high quality research is needed in this area.

C

Noni juice has been used for many years for various conditions in Southeast Asia. Limited research has reviewed the use of noni juice for hearing improvement. Although some benefit was found, further study is needed before conclusions can be made.

C

Limited human research shows that Tahitian Noni® Juice may reduce blood pressure. Lab research suggests that noni may slow or stop the activity of angiotensin converting enzyme, which increases blood pressure. However, further high-quality research is needed to determine the effects of noni alone.

C

According to traditional folk medicine, noni may lower cholesterol. Early research in smokers suggests that Tahitian Noni® Juice may reduce cholesterol and triglycerides in smokers. Although promising, further study is needed before a firm conclusion can be made.

C

Tahitian Noni Juice may have antioxidant benefits and may affect immune activity in healthy people. Noni may decrease malondialdehyde (MDA), a marker of oxidative stress, and may enhance immune function. Although promising, further high-quality research in this area is needed.

C

Early study suggests that people with hip or knee osteoarthritis may experience better quality of life with noni juice consumption. More high-quality research is needed in this field.

C

Applying a one percent noni ointment to the skin may help treat Leishmania major infection. More high-quality research is needed before firm conclusions can be made in this area.

C

* Key to grades

A: Strong scientific evidence for this useB: Good scientific evidence for this useC: Unclear scientific evidence for this useD: Fair scientific evidence for this use (it may not work)F: Strong scientific evidence against this use (it likley does not work)

Tradition / Theory
The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below.

In adults, the highest estimated intake of noni is 624 milliliters daily. However, information suggests that the typical average adult intake of noni is 161 milliliters of M. citrifolia fruit juice. The highest estimated intake of M. citrifolia leaf material in adult males is 1.29 grams daily (equal to 18.4 milligrams per kilogram of body weight in a 70 kilogram person).

As an antioxidant, Tahitian noni juice has been taken by mouth.

To treat cancer, noni has been taken by mouth as: homemade noni juice; 2-10 grams of noni daily (as 500 milligram capsules of freeze-dried noni fruit extract); and two 2 gram noni capsules twice daily, increasing by 2 grams daily to a maximum of 12 grams four times daily.

To treat cervical spondylosis (abnormal wear of the neck bones/cartilage), noni juice has been taken by mouth for four weeks with physical therapy.

To treat hearing loss, 2 ounces of noni juice has been taken by mouth twice daily for three months.

To improve immune function, Tahitian noni juice has been taken by mouth.

To prevent nausea after surgery, doses of 150-600 milligrams of noni extract (containing 1.716-8.712 micrograms of scopoletin) have been taken by mouth one hour before surgery.

To treat parasite infections, one percent M. citrifolia ointment has been applied to sores and ulcers three times daily for up to six weeks.

Children (under 18 years old)

In children, the highest estimated intake of noni is 548 milliliters daily. However, information suggests that the typical average intake of noni is 169 milliliters of M. citrifolia fruit juice. The highest estimated intake of M. citrifolia leaf material in 15 to 18 year-old males is 11.5 milligrams per kilogram of body weight, assuming a body weight of 60 kilograms.

Safety
The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

Avoid in people with a known allergy or sensitivity to noni, its parts, or any plants in the Rubiaceae family.

Side Effects and Warnings

Noni is likely safe when taken by mouth from preparations of fruits and leaves of the noni plant. Noni is likely safe in: typical dietary amounts; up to 750 milliliters of Tahitian Noni® Juice daily for 28 days; and up to six 2 gram noni capsules taken four times daily.

Noni fortified with vitamin K may affect the risk of clotting. Caution is advised in people with bleeding disorders or taking drugs that may affect the risk of bleeding. Dosing adjustments may be necessary.

Noni may cause low blood pressure. Caution is advised in people taking drugs or herbs and supplements that lower blood pressure.

Noni may affect blood sugar levels. Caution is advised in people with diabetes or low blood sugar, and in those taking drugs, herbs, or supplements that affect blood sugar. Blood sugar levels may need to be monitored by a qualified healthcare professional, including a pharmacist, and medication adjustments may be necessary.

Noni may interfere with the way the body processes certain drugs using the liver's "cytochrome P450" enzyme system.

Use cautiously in people who have liver problems. Noni may cause changes in liver enzymes and liver damage.

Use cautiously in people who have stomach or intestine disorders or blockages. Noni may decrease the time it takes for food to pass through the stomach.

Use cautiously in people who are taking agents processed by the UDP-glucuronosyl transferase (UGT) enzyme system. Noni may affect the function of this system.

Noni fortified with vitamin K may affect the risk of clotting when taken with drugs that affect the risk of bleeding. Some examples include aspirin, anticoagulants ("blood thinners") such as warfarin (Coumadin®) or heparin, anti-platelet drugs such as clopidogrel (Plavix®), and non-steroidal anti-inflammatory drugs such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).

Noni may affect blood sugar levels. Caution is advised when using medications that may also affect blood sugar. People taking drugs for diabetes by mouth or insulin should be monitored closely by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.

Noni may interfere with the way the body processes certain drugs using the liver's "cytochrome P450" enzyme system. As a result, the levels of these drugs may be decreased in the blood, and may cause decreased effects or potentially serious adverse reactions. People using any medications should check the package insert, and speak with a qualified healthcare professional, including a pharmacist, about possible interactions.

Noni fortified with vitamin K may affect the risk of clotting when taken with herbs and supplements that are believed to affect the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.

Noni may interfere with the way the body processes certain herbs or supplements using the liver's "cytochrome P450" enzyme system. As a result, the levels of other herbs or supplements may become too low in the blood. It may also alter the effects that other herbs or supplements possibly have on the P450 system.

Noni may affect blood sugar levels. Caution is advised when using herbs or supplements that may also affect blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.

Noni may cause low blood pressure. Caution is advised in people taking herbs or supplements that lower blood pressure.

The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.